ReviewAmerican heart journal plus : cardiology research and practice2026
Beta-blocker therapy after myocardial infarction with preserved LVEF (≥50%): a systematic review and Bayesian meta-analysis with time-to-event reconstruction.
Review in American heart journal plus : cardiology research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: The role of β-blockers in MI with preserved LVEF (≥50%) remains unclear. This Bayesian meta-analysis assessed their effect on mortality and major cardiovascular outcomes. Methods: A systematic search was performed in PubMed, Embase, and Scopus from database inception to September 2025 for studies assessing BB use in post-MI patients with preserved LVEF. All-cause mortality was the primary outcome. A Bayesian random-effects model was applied using the bayesmeta package in RStudio, with effect sizes expressed as risk ratios (RRs) and 95% credible intervals (CrIs). Between-study heterogeneity was assessed through posterior τ estimates. Time-to-event outcomes were analyzed using reconstructed individual patient data from published Kaplan-Meier curves. Results: Six studies, including 17,068 patients, met the inclusion criteria. BB therapy was associated with a posterior risk ratio (RR 0.79; 95% CrI 0.55-1.06) suggesting a possible reduction in all-cause mortality; however, the credible interval included the null, indicating uncertainty in the magnitude or direction of effect. The posterior estimates for cardiovascular death (RR 0.84; 95% CrI 0.55-1.23), stroke (RR 0.92; 95% CrI 0.58-1.49), myocardial infarction (RR 1.04; 95% CrI 0.80-1.40), heart failure (RR 0.84; 95% CrI 0.55-1.23), MACE (RR 1.09; 95% CrI 0.76-1.51), and unplanned revascularization (RR 1.06; 95% CrI 0.75-1.48) also showed wide credible intervals overlapping 1.0, reflecting uncertainty in potential treatment effects. Heterogeneity across outcomes was generally low to moderate. In time-to-event analyses, the frequentist stratified model showed a statistically significant survival benefit with β-blockers (HR 0.87; 95% CI 0.81-0.92), whereas the Bayesian model indicated a similar trend, but the credible interval (HR 0.60; 95% CrI 0.26-1.41) included the null, suggesting no strong evidence of effect. Conclusion: β-blockers were not associated with a clear reduction in all-cause mortality or other outcomes, as credible intervals included the null. Large, randomized trials are needed to define their long-term role in this population.
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